About the ads

Prescribing out of state

Discussion in 'General Residency Issues' started by DeanWormer, Aug 17, 2007.

  1. SDN is a nonprofit organization. Services are made possible through the generous support of SDN members and sponsors. Thank you.
  1. DeanWormer

    DeanWormer Member

    Joined:
    Jan 16, 2006
    Messages:
    69
    Status:
    Attending Physician
    SDN 5+ Year Member

    SDN Members don't see this ad. (About Ads)
    Can you Rx out of your home state with a unrestricted medical license and dea reg.? I live in an area that borders 5 states that draws patients.
  2. Winged Scapula

    Winged Scapula Cougariffic! Administrator Lifetime Donor

    Joined:
    Apr 9, 2000
    Messages:
    30,800
    Location:
    Arizona
    Status:
    Attending Physician
    Physician Faculty SDN 10+ Year Member
    I have found that it seems to depend on the pharmacy.

    Technically, since your DEA is a national license, it shouldn't matter but I have had patients in the past go home and be unable to fill narcotic scripts out of state...I have not had that experience with non-narcs though.

    Perhaps one of the pharm types around here will weigh in on the actual laws.
  3. npage148

    npage148 Senior Member

    Joined:
    May 2, 2005
    Messages:
    1,492
    Location:
    Northeast US
    Status:
    Pharmacist
    Pharmacist PhD SDN 7+ Year Member
    In NY, an out of state prescriber can write for anything they want to as long as it falls in their scope of practice according to NYS laws.

    The first example that pops into my mind is that in NY, OD's can not prescribe oral medications, so if an OD from out of state had the privilege to write for oral medication and wrote for one, it can not be filled in NYS.

    Controls (including CII's are ok) but a lot of pharmacies will verify it by calling the office. Also, we follow the our laws when it comes to dispensing. In NY, there cannot be refills on benzo's so if an out of state doc writes for Xanax with refills, we'll simply cancel the refills
  4. sdn1977

    sdn1977 Senior Member

    Joined:
    Jul 28, 2005
    Messages:
    3,553
    SDN 7+ Year Member
    Like npage, I'm a pharmacist, but in CA. Prescribing (& dispensing) laws are state specific, although we all recoginize your DEA license. Pharmacy is not like medicine - we have 50 states with 50 different sets of laws. What is legal in NJ may not be legal in PA. Recognize your state license to practice whatever field your in is meaningless to us since each state board of "whatever" has its own numbering system (ie - my husband's dental license is exactly the same as one of the neurologists in the area). No one tracks your license - EXCEPT Medicaid (there is ALWAYS an exception in pharmacy).

    You've forgotten to mention the really big # you'll soon (like it was supposed to happen last May...go figure!!!) - your NPI. That will be the number insurers will use to identify you as a prescriber. They have been using the DEA since that is unique solely to you...but, using that for 30 years has caused the DEA #'s to become too public & is something we'd like to restrict to circumstances when you need to prescribed controlled substances. So - come Nov, Dec...who knows - its the govt - whenever...we will be converting over to submitting the NPI for insurance reimbursement. You'll still need a DEA & must stay within the limits of that license (IIN, II, III, IV,V) & hopefullly, the DEA will state just with the prescriber, pharmacy, state boards & DOJ.

    Now - out of state prescribing - that is state specific. My state will allow me to take a valid rx from any prescriber licensed in any state (sadly...this includes natureopaths:(). But, they still must stick within their scopes of practice -see other threads for those caveats.

    Altho I can fill a controlled drug from out of state, I rarely do since those prescribers don't have the CA required form. Under most circumstances - they get called in to me. I call back to verify - if its "odd" or if I get poor feedback from a pharmacy in that prescriber's area - I don't fill. CII's can't get called in, so - no out of state there.

    TX won't take any controlled rxs from any out of state. I can't even transfer my valid rx into them nor can they tx theirs out to me. So, TX residents must have enough supply or they get to spend time in an ER. But, a TX pharmacy will fill a non-controlled drug written by an out of state prescriber. I've had a few patients move to TX & I've had to fill & mail their rxs until they could get set up with a PCP.

    HI won't take a controlled drug transfer, but that's new. I used to be able to transfer there, so I think their laws have changed. I think they'll also fill non-controlled from out of state. I can & do, frequently, transfer rxs back & forth from HI & AZ - big travel states for my population.

    This happens frequently in all states. We've got college kids coming & going, folks going to large regional out of state medical centers for second opinions, travelers, etc...

    Are you asking out of curiousity or did you find yourself in an actual incident? Calling the pharmacy might get you your specific reason.
  5. npage148

    npage148 Senior Member

    Joined:
    May 2, 2005
    Messages:
    1,492
    Location:
    Northeast US
    Status:
    Pharmacist
    Pharmacist PhD SDN 7+ Year Member
    Luckily, nautropaths are not recognized in NYS so we don't have to deal with them.

    One last thing, in NYS, PA's can not write for CII's outpatient and we are not allowed to transfer controls ever
  6. Hmmm, I was under the impression that my prescriptions aren't valid out-of-state. We get this problem from time to time with all of our out-of-state traumas.
  7. sdn1977

    sdn1977 Senior Member

    Joined:
    Jul 28, 2005
    Messages:
    3,553
    SDN 7+ Year Member
    Nope - I've got lots of pts who seek tx at research facilities across the country - MD Anderson, Mayo Clinic, Harvard, etc.....they see their physicians every 2-3 months & will write the rxs. If its controlled drugs, they call me or have the local PCP write them.

    Then - there are all the college students who have their OCP's & acne medication prescribed by the student health center physicians. They go home & we honor them, if the state allows.
  8. All4MyDaughter

    All4MyDaughter SDN Mommystrator Staff Member Administrator SDN Senior Moderator Lifetime Donor Partner Organization

    Joined:
    May 7, 2005
    Messages:
    22,646
    Location:
    Cube Farm
    Status:
    Pharmacist
    Pharmacist SDN Partner SDN Published Author NCPA Kappa Psi SDN 7+ Year Member

    This is a common misperception. My pediatrician didn't think he could call in a medicine for my daughter when we were on vacation in Tennessee. Or, he just didn't want to do it. 50/50 :laugh:
  9. All4MyDaughter

    All4MyDaughter SDN Mommystrator Staff Member Administrator SDN Senior Moderator Lifetime Donor Partner Organization

    Joined:
    May 7, 2005
    Messages:
    22,646
    Location:
    Cube Farm
    Status:
    Pharmacist
    Pharmacist SDN Partner SDN Published Author NCPA Kappa Psi SDN 7+ Year Member
    In Ky we can fill from any state but the prescription must meet Kentucky state law concerning prescriber scope, # of refills, etc.

    So no controls from PAs and only limited controls from ARNPs, etc. And so on. No naturopaths or homeopaths or chiropractors.
  10. Hmmm...interesting. Wonder why my co-residents and I have had problems in the past, then?
  11. Winged Scapula

    Winged Scapula Cougariffic! Administrator Lifetime Donor

    Joined:
    Apr 9, 2000
    Messages:
    30,800
    Location:
    Arizona
    Status:
    Attending Physician
    Physician Faculty SDN 10+ Year Member
    Do you have a DEA or are you using a hospital issued one?

    Are you working on a training license or a full unrestricted one?

    I had problems in the past, but it was generally before I had the above Can't say I recall any such problems since.
  12. Well, I'd been using my program's institutional DEA number and I had a training license.

    We'll see if things are different now.

Share This Page


About the ads